In a new Committee Opinion, ACOG recommends that obstetric care providers counsel their patients on the option of using immediate postpartum Long-Acting Reversible Contraception (LARC) during their prenatal appointments. Immediate postpartum LARC allows women to prevent an unplanned pregnancy and can be inserted before they have even left the hospital after delivery. This is a convenient option for all women, and can be specifically beneficial for populations of women at the highest risk of unplanned pregnancies, including younger women ages 18-24, minority women, and women of low socioeconomic status. Out of all women who deliver in hospitals, only 40 percent attend their follow up appointment. For those that do attend their follow-up appointment, they may face barriers to receiving LARC, such as loss of insurance coverage or an additional appointment needed for the placement of LARC. ACOG supports expansion of institutional and payment policy changes to help make LARC more accessible and affordable. Implementing LARC immediately following delivery streamlines women’s access to LARC and reduces the barriers to contraception that women face.

In a newly revised Committee Opinion, ACOG states that, although each woman has the right to make her own decision about delivery, women should be medically informed about the risks and benefits associated with their decisions, should they choose to have a planned home birth. Since home births are associated with an increased risk of neonatal seizures or serious neurological dysfunction, ACOG maintains that hospitals and accredited birth centers are the safest settings for delivery. This updated Committee Opinion reflects updated evidence that supports ACOG’s position, held since 2011, that home births carry increased risk.

Joseph R. Wax, MD, a primary author of this Committee Opinion, notes that “Obstetrician-gynecologists recognize that women are seeking home births for a variety of reasons. Our goal is to help them understand and balance the benefits with the risks by providing information to help them come to a medically informed decision.”

Featured Practice Advisory: Low-Dose Aspirin and Prevention of Preeclampsia

This Practice Advisory includes updated recommendations based on a clinical guideline published September 2014 by the US Preventative Services Task Force (USPSTF). Although ACOG’s original recommendations and USPSTF’s guidelines both address women at high-risk for preeclampsia, the criteria for determining high-risk are more expansive in USPSTF’s recommendations. ACOG encourages the use of USPSTF’s criteria for determining women at high-risk for preeclampsia and supports the recommendation to consider the use of low-dose aspirin (81 mg/day) between 12 and 28 weeks of gestation.